Provider Demographics
NPI:1700090974
Name:COLE, DEANNA JO (COTA)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:JO
Last Name:COLE
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 ALPINE VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-3736
Mailing Address - Country:US
Mailing Address - Phone:724-325-7561
Mailing Address - Fax:
Practice Address - Street 1:2030 ADER RD
Practice Address - Street 2:
Practice Address - City:JEANNETTE
Practice Address - State:PA
Practice Address - Zip Code:15644-4500
Practice Address - Country:US
Practice Address - Phone:724-325-6396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP001644L224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant